{"id":67408,"date":"2026-10-14T22:48:50","date_gmt":"2026-10-15T03:48:50","guid":{"rendered":"https:\/\/osteomag.ca\/?p=67408"},"modified":"2026-10-14T22:48:50","modified_gmt":"2026-10-15T03:48:50","slug":"hypermobility-does-being-very-flexible-mean-your-joints-are-fragile","status":"publish","type":"post","link":"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/","title":{"rendered":"Hypermobility: Does Being Very Flexible Mean Your Joints Are Fragile?"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_89 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #000000;color:#000000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #000000;color:#000000\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#A_large_range_of_motion_instability_and_symptoms_are_not_the_same_thing\" >A large range of motion, instability and symptoms are not the same thing<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#What_is_a_hypermobile_joint\" >What is a hypermobile joint?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Is_being_flexible_dangerous\" >Is being flexible dangerous?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Hypermobility_and_instability_are_not_the_same\" >Hypermobility and instability are not the same<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#What_is_the_Beighton_score\" >What is the Beighton score?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Does_a_high_Beighton_score_mean_hEDS\" >Does a high Beighton score mean hEDS?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Do_thresholds_change_with_age\" >Do thresholds change with age?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Why_does_the_Beighton_score_have_limitations\" >Why does the Beighton score have limitations?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#What_is_a_hypermobility_spectrum_disorder\" >What is a hypermobility spectrum disorder?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#What_is_hEDS\" >What is hEDS?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Is_there_a_genetic_test_for_hEDS\" >Is there a genetic test for hEDS?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Why_should_self-diagnosis_be_avoided\" >Why should self-diagnosis be avoided?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Are_hypermobile_joints_more_fragile\" >Are hypermobile joints more fragile?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Why_do_some_people_sustain_more_injuries\" >Why do some people sustain more injuries?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Is_proprioception_different\" >Is proprioception different?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Is_strengthening_important\" >Is strengthening important?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Should_heavy_weights_be_avoided\" >Should heavy weights be avoided?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Should_all_extreme_ranges_be_avoided\" >Should all extreme ranges be avoided?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Stretching_useful_or_best_avoided\" >Stretching: useful or best avoided?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Why_do_some_people_nevertheless_feel_very_stiff\" >Why do some people nevertheless feel very stiff?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Shoulder_pain_and_hypermobility\" >Shoulder pain and hypermobility<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#The_knee_and_kneecap\" >The knee and kneecap<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#The_ankle_and_repeated_sprains\" >The ankle and repeated sprains<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Should_splints_be_worn_all_the_time\" >Should splints be worn all the time?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Is_manual_therapy_useful\" >Is manual therapy useful?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-26\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#When_should_another_connective_tissue_disorder_be_investigated\" >When should another connective tissue disorder be investigated?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-27\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Is_hEDS_only_a_musculoskeletal_condition\" >Is hEDS only a musculoskeletal condition?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-28\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Why_does_physical_activity_remain_important\" >Why does physical activity remain important?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-29\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#What_is_the_role_of_osteopathy\" >What is the role of osteopathy?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-30\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Language_that_helps_rather_than_alarms\" >Language that helps rather than alarms<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-31\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#Conclusion\" >Conclusion<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-32\" href=\"https:\/\/osteomag.ca\/en\/hypermobility-does-being-very-flexible-mean-your-joints-are-fragile\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n<div class=\"osteomag-a0\" lang=\"en\">\n<style>.osteomag-a0 img{max-width:100%;height:auto}.osteomag-a0 figure{text-align:center;margin:1.5em auto}.osteomag-a0 figcaption{font-size:.92em;line-height:1.5}.osteomag-a0 table{border-collapse:collapse;width:100%;font-size:.94em;line-height:1.45}.osteomag-a0 td,.osteomag-a0 th{padding:.65em;border:1px solid #ccd4dc;vertical-align:top}.osteomag-a0 th{background:#eef3f7}.osteomag-a0 caption{text-align:left;font-weight:600;margin-bottom:.5em}.osteomag-a0 .osteomag-references{padding-left:1.4em;list-style-type:disc}.osteomag-a0 .osteomag-references li{margin-bottom:.6em;overflow-wrap:anywhere}.osteomag-a0 .osteomag-cite{color:#0869c5!important;text-decoration:underline!important}<\/style>\n<h2><span class=\"ez-toc-section\" id=\"A_large_range_of_motion_instability_and_symptoms_are_not_the_same_thing\"><\/span>A large range of motion, instability and symptoms are not the same thing<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Being very flexible is not necessarily a problem. Some people can place their hands on the floor, bend their thumbs a long way or hyperextend their knees without pain or limitation. In others, this extensive mobility comes with pain, instability, repeated sprains, subluxations or substantial fatigue.<\/p>\n<p>The term <strong>hypermobility<\/strong> describes a joint range greater than average. However, asymptomatic flexibility must be distinguished from a clinical condition such as hypermobility spectrum disorder (HSD) or hypermobile Ehlers-Danlos syndrome (hEDS). <strong>Being very flexible does not automatically mean that joints are fragile or diseased.<\/strong><\/p>\n<figure class=\"wp-block-image aligncenter\"><img decoding=\"async\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en.webp\" alt=\"Three educational scenes: flexibility, symptoms and function: three different questions.\" width=\"1200\" height=\"675\" class=\"wp-image-67436\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en.webp 1200w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-540x304.webp 540w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-1030x579.webp 1030w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-80x45.webp 80w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-768x432.webp 768w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-747x420.webp 747w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-150x84.webp 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-300x169.webp 300w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-600x338.webp 600w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-696x392.webp 696w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-1-en-1068x601.webp 1068w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><figcaption>Flexibility, symptoms and function: three different questions. Educational illustration: these situations are not individual treatment prescriptions.<\/figcaption><\/figure>\n<h2><span class=\"ez-toc-section\" id=\"What_is_a_hypermobile_joint\"><\/span>What is a hypermobile joint?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A joint is described as hypermobile when it exceeds the range usually expected for the person&#8217;s age, sex, body build and context.<\/p>\n<p>Hypermobility may be:<\/p>\n<ul>\n<li>localized to one or a few joints;<\/li>\n<li>peripheral, for example in the hands and feet;<\/li>\n<li>generalized, affecting several body regions.<\/li>\n<\/ul>\n<p>It may be constitutional and symptom-free, or become clinically relevant when associated with pain or instability.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Is_being_flexible_dangerous\"><\/span>Is being flexible dangerous?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Not in itself.<\/p>\n<p>Many hypermobile people have neither pain nor functional problems. Some sports and performing arts even naturally select highly flexible people.<\/p>\n<p>Problems mainly arise when mobility exceeds the joint&#8217;s capacity for control, strength or tolerance.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Hypermobility_and_instability_are_not_the_same\"><\/span>Hypermobility and instability are not the same<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A joint can have a large range of motion while remaining stable.<\/p>\n<p>Instability refers more to difficulty controlling the joint, a feeling that it &#8216;gives way&#8217;, subluxations or dislocations.<\/p>\n<p>A strong, coordinated, asymptomatic hypermobile person does not need treatment simply because they move beyond certain ranges.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"What_is_the_Beighton_score\"><\/span>What is the Beighton score?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The Beighton score is a clinical tool used to screen for generalized hypermobility.<\/p>\n<p>It awards up to nine points based on several movements:<\/p>\n<ul>\n<li>little-finger hyperextension;<\/li>\n<li>the thumb touching the forearm;<\/li>\n<li>elbow hyperextension;<\/li>\n<li>knee hyperextension;<\/li>\n<li>placing both palms flat on the floor with straight knees.<\/li>\n<\/ul>\n<p>It is simple and widely used, but does not measure every joint in the body.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Does_a_high_Beighton_score_mean_hEDS\"><\/span>Does a high Beighton score mean hEDS?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>No.<\/p>\n<p>The Beighton score is one component of screening for generalized hypermobility. It is not sufficient to diagnose hypermobile Ehlers-Danlos syndrome.<\/p>\n<p>An hEDS diagnosis depends on a set of clinical criteria involving generalized hypermobility, systemic or family features, musculoskeletal complications and exclusion of other diagnoses.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Do_thresholds_change_with_age\"><\/span>Do thresholds change with age?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Yes. Joint mobility generally decreases with age.<\/p>\n<p>Current hEDS criteria use a Beighton threshold of 5\/9 in adults up to age 50 and 4\/9 after 50.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-1\" aria-label=\"Reference 1\">[1]<\/a><\/sup><\/span><\/p>\n<p>A recent meta-analysis of the general adult population also supports age-adjusted thresholds.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-2\" aria-label=\"Reference 2\">[2]<\/a><\/sup><\/span><\/p>\n<p>These population-derived screening thresholds do not replace current hEDS diagnostic criteria. In children before biological maturity, the 2023 paediatric framework uses a Beighton score of at least 6\/9 for generalized hypermobility; assessment for hEDS is revisited at maturity.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-3\" aria-label=\"Reference 3\">[3]<\/a><\/sup><\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Why_does_the_Beighton_score_have_limitations\"><\/span>Why does the Beighton score have limitations?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>It does not directly assess several important joints, including the shoulders, hips, ankles or spine.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-4\" aria-label=\"Reference 4\">[4]<\/a><\/sup><\/span><\/p>\n<p>Someone can therefore have substantial hypermobility in these regions yet receive a relatively low score.<\/p>\n<p>Conversely, a high score does not necessarily mean that the joints are symptomatic.<\/p>\n<p>The score must be interpreted within a broader examination.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"What_is_a_hypermobility_spectrum_disorder\"><\/span>What is a hypermobility spectrum disorder?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>HSD encompasses people with hypermobility associated with clinically significant symptoms who do not meet the criteria for hEDS or another hereditary connective tissue disorder.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-5\" aria-label=\"Reference 5\">[5]<\/a><\/sup><\/span><\/p>\n<p>HSD is not automatically a milder condition: pain and functional impact can be substantial even without meeting hEDS criteria.<\/p>\n<p>Symptoms may include:<\/p>\n<ul>\n<li>recurrent joint pain;<\/li>\n<li>frequent sprains;<\/li>\n<li>subluxations;<\/li>\n<li>muscle fatigue;<\/li>\n<li>difficulty controlling certain ranges;<\/li>\n<li>pain after prolonged positions.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"What_is_hEDS\"><\/span>What is hEDS?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Hypermobile Ehlers-Danlos syndrome is a clinically defined hereditary connective tissue disorder.<\/p>\n<p>Clinical descriptions of hEDS include hypermobility, instability, pain and sometimes skin or systemic features. None of these alone establishes the diagnosis, which also requires exclusion of other conditions.<\/p>\n<p>Diagnosis must also exclude other hereditary or rheumatological conditions that may cause hypermobility.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Is_there_a_genetic_test_for_hEDS\"><\/span>Is there a genetic test for hEDS?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>At present, no molecular test establishes an hEDS diagnosis.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-6\" aria-label=\"Reference 6\">[6]<\/a><\/sup><\/span><\/p>\n<p>Unlike several other types of Ehlers-Danlos syndrome, no single confirmed gene is currently used in routine practice to diagnose hEDS.<\/p>\n<p>Diagnosis therefore remains clinical.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Why_should_self-diagnosis_be_avoided\"><\/span>Why should self-diagnosis be avoided?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Hypermobility is relatively common in the population.<\/p>\n<p>Automatically linking fatigue, widespread pain or joint clicking to hEDS can lead to overdiagnosis.<\/p>\n<p>Other causes must be considered: osteoarthritis, inflammatory diseases, neuropathies, endocrine disorders, deconditioning or common musculoskeletal pain conditions.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Are_hypermobile_joints_more_fragile\"><\/span>Are hypermobile joints more fragile?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>They may be harder to control in some people, but &#8216;fragile&#8217; can be a misleading word.<\/p>\n<p>A hypermobile joint is not necessarily deteriorating.<\/p>\n<p>The main clinical issues are often active control, strength, coordination and the ability to manage repeated loading.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Why_do_some_people_sustain_more_injuries\"><\/span>Why do some people sustain more injuries?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A large range combined with limited control may increase the risk of certain sprains, subluxations or overload.<\/p>\n<p>However, risk varies by joint, sport and individual. An older meta-analysis found increased knee injury risk in contact sports, without a demonstrated increase at the ankle. These findings do not mean that every hypermobile person will sustain more injuries.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-7\" aria-label=\"Reference 7\">[7]<\/a><\/sup><\/span><\/p>\n<p>It would therefore be incorrect to say that every hypermobile person should avoid physical activity.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Is_proprioception_different\"><\/span>Is proprioception different?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Some studies suggest differences in proprioception or motor control in people with HSD or hEDS.<\/p>\n<p>Proprioception is the ability to sense a joint&#8217;s position and movement.<\/p>\n<p>Control, balance and precision exercises may therefore help when someone feels unstable.<\/p>\n<div class=\"osteomag-table-wrap\" style=\"overflow-x:auto\">\n<table>\n<caption>Distinguishing range of motion from a clinical disorder<\/caption>\n<thead>\n<tr>\n<th scope=\"col\">Situation<\/th>\n<th scope=\"col\">What matters<\/th>\n<th scope=\"col\">Approach<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Large range without symptoms<\/td>\n<td>Preserved function<\/td>\n<td>No treatment based on the score alone.<\/td>\n<\/tr>\n<tr>\n<td>Large range with pain or instability<\/td>\n<td>Impact and possible causes<\/td>\n<td>Individual assessment and active progression.<\/td>\n<\/tr>\n<tr>\n<td>Suspected HSD or hEDS<\/td>\n<td>Full criteria and alternative diagnoses<\/td>\n<td>Clinical assessment, not self-diagnosis from a photograph.<\/td>\n<\/tr>\n<tr>\n<td>Tissue fragility or an unusual family history<\/td>\n<td>Possible other connective tissue disorder<\/td>\n<td>Specialist referral.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<figure class=\"wp-block-image aligncenter\"><img decoding=\"async\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en.webp\" alt=\"Three educational scenes: hypermobility: building control.\" width=\"1200\" height=\"675\" class=\"wp-image-67439\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en.webp 1200w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-540x304.webp 540w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-1030x579.webp 1030w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-80x45.webp 80w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-768x432.webp 768w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-747x420.webp 747w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-150x84.webp 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-300x169.webp 300w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-600x338.webp 600w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-696x392.webp 696w, https:\/\/osteomag.ca\/wp-content\/uploads\/2026\/10\/osteomag-60219-2-en-1068x601.webp 1068w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><figcaption>Hypermobility: building control. Educational illustration: these situations are not individual treatment prescriptions.<\/figcaption><\/figure>\n<h2><span class=\"ez-toc-section\" id=\"Is_strengthening_important\"><\/span>Is strengthening important?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Yes. Reviews of rehabilitation for HSD\/hEDS mainly support approaches based on therapeutic exercise and motor control training.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-8\" aria-label=\"Reference 8\">[8]<\/a><\/sup><\/span><span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-9\" aria-label=\"Reference 9\">[9]<\/a><\/sup><\/span><\/p>\n<p>Strengthening may improve:<\/p>\n<ul>\n<li>active stability;<\/li>\n<li>strength;<\/li>\n<li>endurance;<\/li>\n<li>confidence;<\/li>\n<li>the ability to tolerate daily activities.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Should_heavy_weights_be_avoided\"><\/span>Should heavy weights be avoided?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Not necessarily.<\/p>\n<p>A hypermobile person can progress towards substantial loads if technique, capacity and tolerance allow.<\/p>\n<p>Progression must be gradual, especially when joints have previously been unstable or painful.<\/p>\n<p>A trial in adults with HSD and shoulder symptoms suggests possible benefits from heavier, supervised strengthening. It involved a specific population and more transient muscle soreness or headaches; it does not justify heavy loading for everyone.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-10\" aria-label=\"Reference 10\">[10]<\/a><\/sup><\/span><\/p>\n<p>The issue is not the weight itself, but a load poorly matched to current capacity.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Should_all_extreme_ranges_be_avoided\"><\/span>Should all extreme ranges be avoided?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>No, but it may help not to spend prolonged periods at end range when that position causes pain or instability.<\/p>\n<p>A person can learn to control their full range rather than routinely &#8216;locking&#8217; joints into hyperextension.<\/p>\n<p>The aim is not to become stiff, but to gain control.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Stretching_useful_or_best_avoided\"><\/span>Stretching: useful or best avoided?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Stretching is not prohibited.<\/p>\n<p>However, continually seeking greater range is not necessarily useful for someone who is already very mobile.<\/p>\n<p>If a stretch provides relief without increasing instability, it can be retained. The goal should remain functional.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Why_do_some_people_nevertheless_feel_very_stiff\"><\/span>Why do some people nevertheless feel very stiff?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>This is a common paradox: a hypermobile person may experience substantial muscle tension.<\/p>\n<p>Muscles may increase their activity to stabilize very mobile joints. Someone can therefore have a large objectively measured range while feeling considerable subjective stiffness.<\/p>\n<p>This feeling does not necessarily mean that more stretching is needed.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Shoulder_pain_and_hypermobility\"><\/span>Shoulder pain and hypermobility<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The shoulder is naturally very mobile. In some people with HSD\/hEDS, multidirectional instability can make overhead activities or repeated movements difficult.<\/p>\n<p>A recent systematic review of shoulder symptoms in hEDS\/HSD reports improvements with several conservative interventions, while emphasizing the lack of robust studies.<span> <sup><a class=\"osteomag-cite\" style=\"color:#0869c5!important;text-decoration:underline\" href=\"#ref-60219-en-11\" aria-label=\"Reference 11\">[11]<\/a><\/sup><\/span><\/p>\n<p>Exercise generally remains central to care.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"The_knee_and_kneecap\"><\/span>The knee and kneecap<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Hypermobility may sometimes involve greater kneecap mobility or episodes of instability.<\/p>\n<p>Quadriceps and hip strengthening, together with lower-limb control, are then often more useful than trying to &#8216;put the kneecap back into place&#8217;.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"The_ankle_and_repeated_sprains\"><\/span>The ankle and repeated sprains<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>A very mobile person may experience frequent sprains.<\/p>\n<p>Balance work, fibularis muscle strengthening, single-leg stance control and progressive return to sport are particularly important.<\/p>\n<p>A brace may help temporarily during certain higher-risk activities.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Should_splints_be_worn_all_the_time\"><\/span>Should splints be worn all the time?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Not routinely.<\/p>\n<p>Orthoses may help particular joints or activities. Duration of use is decided individually: long-term support may be indicated and should not automatically be described as harmful. Active work is included where possible.<\/p>\n<p>The choice depends on the degree of instability, pain and function.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Is_manual_therapy_useful\"><\/span>Is manual therapy useful?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>It may temporarily reduce pain or improve comfort.<\/p>\n<p>However, seeking even more mobility is not always relevant for someone who is already hypermobile.<\/p>\n<p>Available reviews provide more support for exercise and motor control than for manual therapy as the main intervention.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"When_should_another_connective_tissue_disorder_be_investigated\"><\/span>When should another connective tissue disorder be investigated?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Hypermobility associated with unusual signs warrants more specialized assessment.<\/p>\n<p>Examples include:<\/p>\n<ul>\n<li>marked skin fragility;<\/li>\n<li>highly atypical scars;<\/li>\n<li>vascular or organ ruptures;<\/li>\n<li>frequent dislocations without trauma;<\/li>\n<li>a family history of severe vascular complications;<\/li>\n<li>unusual body features or systemic abnormalities.<\/li>\n<\/ul>\n<p>These findings may point towards other types of Ehlers-Danlos syndrome or other hereditary disorders.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Is_hEDS_only_a_musculoskeletal_condition\"><\/span>Is hEDS only a musculoskeletal condition?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>No. Some people also experience fatigue, sleep problems, autonomic symptoms, digestive symptoms or pelvic symptoms.<\/p>\n<p>However, these symptoms are nonspecific and may have many other causes.<\/p>\n<p>They should be assessed separately rather than automatically attributed to hypermobility.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Why_does_physical_activity_remain_important\"><\/span>Why does physical activity remain important?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Inactivity reduces strength, endurance and confidence, which can make joints even harder to control.<\/p>\n<p>A progressive programme may include:<\/p>\n<ul>\n<li>strengthening;<\/li>\n<li>motor control;<\/li>\n<li>balance;<\/li>\n<li>endurance;<\/li>\n<li>functional exercises;<\/li>\n<li>a gradual return to sport.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"What_is_the_role_of_osteopathy\"><\/span>What is the role of osteopathy?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Osteopathy may contribute to comfort and management of some pain, but must not treat every hypermobile joint as &#8216;displaced&#8217; or requiring repeated correction.<\/p>\n<p>For a hypermobile person, manual treatment should be cautious and function-oriented.<\/p>\n<p>Active strength and control work generally remain more important for long-term stability.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Language_that_helps_rather_than_alarms\"><\/span>Language that helps rather than alarms<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Telling someone &#8216;your joints are fragile and keep moving out of place&#8217; can increase fear of movement.<\/p>\n<p>A more useful explanation would be:<\/p>\n<p><strong>&#8216;Your range is greater than average. The main aim is to improve your control and your ability to use that range comfortably.&#8217;<\/strong><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Conclusion\"><\/span>Conclusion<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Hypermobility is not synonymous with disease. Many very flexible people are asymptomatic and need no treatment.<\/p>\n<p>When accompanied by pain, instability or repeated dislocations, it may be part of a hypermobility spectrum disorder or, in some cases, hEDS.<\/p>\n<p>The Beighton score is useful for screening but not sufficient for diagnosis. <strong>The most important question is not just how far a joint moves, but how the person controls that movement and functions.<\/strong><\/p>\n<p>The strongest strategy generally remains progressive: strength, motor control, endurance, activity adaptation and reassurance\u2014without trying to turn a naturally flexible person into a stiff one.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul class=\"osteomag-references\" style=\"list-style-type:disc\">\n<li id=\"ref-60219-en-1\">[1] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28306229\/\" target=\"_blank\" rel=\"noopener\">Malfait F, Francomano C, Byers P et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet. 2017;175(1):8-26. doi:10.1002\/ajmg.c.31552.<\/a><\/li>\n<li id=\"ref-60219-en-2\">[2] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41399207\/\" target=\"_blank\" rel=\"noopener\">Tofts L, Pacey V, Williams CM et al. Generalized Joint Hypermobility in Adults: A Systematic Review With Meta-Analysis to Identify Data-Driven Cut-offs Using the Beighton Score. Arthritis Care Res (Hoboken). 2026;78(8):987-997. doi:10.1002\/acr.70017.<\/a><\/li>\n<li id=\"ref-60219-en-3\">[3] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37143135\/\" target=\"_blank\" rel=\"noopener\">Tofts LJ, Simmonds J, Schwartz SB et al. Pediatric joint hypermobility: a diagnostic framework and narrative review. Orphanet J Rare Dis. 2023;18(1):104. doi:10.1186\/s13023-023-02717-2.<\/a><\/li>\n<li id=\"ref-60219-en-4\">[4] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33738549\/\" target=\"_blank\" rel=\"noopener\">Malek S, Reinhold EJ, Pearce GS. The Beighton Score as a measure of generalised joint hypermobility. Rheumatol Int. 2021;41(10):1707-1716. doi:10.1007\/s00296-021-04832-4.<\/a><\/li>\n<li id=\"ref-60219-en-5\">[5] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28145606\/\" target=\"_blank\" rel=\"noopener\">Castori M, Tinkle B, Levy H et al. A framework for the classification of joint hypermobility and related conditions. Am J Med Genet C Semin Med Genet. 2017;175(1):148-157. doi:10.1002\/ajmg.c.31539.<\/a><\/li>\n<li id=\"ref-60219-en-6\">[6] <a href=\"https:\/\/www.ehlers-danlos.com\/diagnosis\/\" target=\"_blank\" rel=\"noopener\">The Ehlers-Danlos Society. Diagnosis. Clinical criteria for hEDS and HSD; no routine diagnostic laboratory test. Accessed October 15, 2026.<\/a><\/li>\n<li id=\"ref-60219-en-7\">[7] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20601606\/\" target=\"_blank\" rel=\"noopener\">Pacey V, Nicholson LL, Adams RD et al. Generalized joint hypermobility and risk of lower limb joint injury during sport: a systematic review with meta-analysis. Am J Sports Med. 2010;38(7):1487-97. doi:10.1177\/0363546510364838.<\/a><\/li>\n<li id=\"ref-60219-en-8\">[8] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37231592\/\" target=\"_blank\" rel=\"noopener\">Garreth Brittain M, Flanagan S, Foreman L et al. Physical therapy interventions in generalized hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome: a scoping review. Disabil Rehabil. 2024;46(10):1936-1953. doi:10.1080\/09638288.2023.2216028.<\/a><\/li>\n<li id=\"ref-60219-en-9\">[9] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35756986\/\" target=\"_blank\" rel=\"noopener\">Buryk-Iggers S, Mittal N, Santa Mina D et al. Exercise and Rehabilitation in People With Ehlers-Danlos Syndrome: A Systematic Review. Arch Rehabil Res Clin Transl. 2022;4(2):100189. doi:10.1016\/j.arrct.2022.100189.<\/a><\/li>\n<li id=\"ref-60219-en-10\">[10] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/35649707\/\" target=\"_blank\" rel=\"noopener\">Liaghat B, Skou ST, S\u00f8ndergaard J et al. Short-term effectiveness of high-load compared with low-load strengthening exercise on self-reported function in patients with hypermobile shoulders: a randomised controlled trial. Br J Sports Med. 2022;56(22):1269-76. doi:10.1136\/bjsports-2021-105223.<\/a><\/li>\n<li id=\"ref-60219-en-11\">[11] <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39372240\/\" target=\"_blank\" rel=\"noopener\">Higo A, Palmer S, Liaghat B et al. The Effectiveness of Conservative Interventions on Pain, Function, and Quality of Life in Adults with Hypermobile Ehlers-Danlos Syndrome\/Hypermobility Spectrum Disorders and Shoulder Symptoms: A Systematic Review. Arch Rehabil Res Clin Transl. 2024;6(3):100360. doi:10.1016\/j.arrct.2024.100360.<\/a><\/li>\n<\/ul>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>A large range of motion is not the same as instability or disease. Learn how hypermobility, HSD and hEDS are assessed, and why strength, control and individualized progression matter.<\/p>\n","protected":false},"author":1,"featured_media":61441,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","footnotes":""},"categories":[],"tags":[],"class_list":["post-67408","post","type-post","status-publish","format-standard","has-post-thumbnail"],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/67408","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/comments?post=67408"}],"version-history":[{"count":2,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/67408\/revisions"}],"predecessor-version":[{"id":67457,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/67408\/revisions\/67457"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/media\/61441"}],"wp:attachment":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/media?parent=67408"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/categories?post=67408"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/tags?post=67408"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}